The purpose of this proposal is to develop baseline data on individuals 65 years and older who have elected to undergo surgery for spinal degenerative myeloradiculopathy (SDM). SDM is the 4th most prevalent selected chronic condition in persons 65 and older in the U.S. and while the prevalence of back impairment has remained essential stable between 1982 and 1987, the surgical procedure rate has increased 60%. The literature on the effectiveness of surgery and rehabilitation in patients 65 and older in restoring impaired functional status, or maintaining this at the highest possible level, is limited. We have access to the Medicare database (US 82 Billing forms) for 1986; specifically we intend to analyze the database for national and regional trends for the three major surgical procedures for SDM, exploration and decompression of the spinal canal structures, excision or destruction of intervertebral disc and spinal fusion, with respect to patient and hospital characteristics, describing and documenting outcomes such as mortality, readmission, repeat procedure, length of stay, discharge locations and reimbursement. In addition, we intend to investigate the feasibility of using techniques, originally developed for other populations, to measure functional status (physical activity patterns, exercise tolerance and quality of life) before and after surgery for SDM in patients 65 years and older, and to correlate these findings with routinely measured mechanical outcomes. Specifically,l we intend to recruit patients 65 years of age and older an document 1) changes in physical activity patterns using an electronic accelerometer motion activity sensor, 2) changes in exercise tolerance using progressive graded exercise testing on a cycle ergometer and a treadmill and 3) changes in quality of life in an index validated on younger patients with chronic low back pain and if necessary adapt the index for use in older patients. Baseline data of these kinds and evidence of the usefulness of existing assessment techniques to determine change are needed before attempting to design randomized trials of the role of exercise in the rehabilitation of older patients undergoing elective surgery for SDM.